Customer Online Application

Applicant Co-Applicant
  Co-Applicant Name (if applicable)
Title required
First Name required
Middle Name required
Last Name required
Date of Birth required
SIN required
Marital Status required
Home Phone required
Cell Phone

Current Address

Number required
Apartment Number
Street Name required
City required
Province required
Postal Code required
Years at Address required
Months at Address required

Previous Address

(if less than 2 years)
Apartment Number
Street Name
Postal Code
Years at Address
Months at Address

Present Employment

Employment Type required
Employer required
Occupation required
Address required
City required
Province required
Phone required
Years Employed required
Months Employed required

Previous Employment

(if less than 2 years at current)
Employment Type
Years Employed
Months Employed

Financial Details

Gross Monthly Income required
Other Monthly Income
Description of Other
Total Monthly Income required

Financial Obligations

Home Status required
Landlord/Mortgage Holder
Monthly Payment required
Market Value
Mortgage Balance
Original Mortgage Amount

Have you claimed bankruptcy in the last 7 years? (yes/no *required)

Are you currently past due on payments? (yes/no *required)
Do you have any collection outstanding? (yes/no *required)
By accepting below means that all the information I have provided is to the best of my knowledge truthful. I hereby authorize EPIC Dealer Solutions Ltd. and credit lenders to obtain and exchange and release my credit report, personal information, and make any necessary inquiries regarding our loan application for the purpose of interested lenders providing funds on our behalf for our conditional vehicle purchase. I authorize those lending institutions who approve this loan application and are willing to provide funds on our behalf to forward a copy of the final loan agreement and all other relevant documents to EPIC Dealer Solutions or to the automobile dealership listed on page one of this application.

I accept (required)

Please double check your information before proceeding. Once you submit the form, we will respond to your request as soon as possible.

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EPIC is a proud member of the
Manitoba Used Car Dealer
Association (MUCDA)

   Epic Dealer Solutions Ltd. is a BBB Accredited Financial Service in Winnipeg, MB